Walking Aid and Locomotion Knowledge in Emergency Rooms (WALKER 1) for Elderly People

NCT05950269 | Completed DMC

• 1 other identifier: AVAP-NG 2999
• Study Type: interventional
• Target: 153
• Locations: 1 country
• Sites: 1

Brief Summary

Older adults have higher rates of emergency department admissions when compared to their younger counterparts. Mobility is the ability to move around but also encompasses the environment and the ability to adapt to it. Walking aids can be used to improve mobility and prevent falls. According to international guidelines, they must be available in Geriatric Emergency Department. This study aims to evaluate the effectiveness of a program of training and provision of walking aids (WA), associated or not with telemonitoring, on mobility, quality of life, fear of falling, and risk of falls up to 3 months in older adults cared for in an emergency department.

Conditions

Mobility Limitation

Keywords

Geriatric; Life space; Walking aids; Emergency room; Clinical Trial; Mobility

Outcome Measures

Primary Outcomes (2)

• Life-Space Assessment (LSA)

  LSA is a scale which allows the characterization of mobility in life-spaces specifically frequency, need for mobility aids and the help of third party in the last 4 weeks

  At baseline and after completion of the 3 and 6 months intervention to assess change

• Falls Efficacy Scale International (FES-I)

  Assesses fear of falling

  At baseline, immediately after the intervention and after completion of the 3 and 6 months intervention to assess change

Secondary Outcomes (9)

• Timed Up and Go test (TUG)

  At baseline and immediately after the intervention

• One-minute sit-to-stand test

  At baseline and after completion of the 3 and 6 months intervention to assess change

• Katz index

  At baseline and after completion of the 3 and 6 months intervention to assess change

• Barthel index

  At baseline and after completion of the 3 and 6 months intervention to assess change

• Lawton-Brody scale

  At baseline and after completion of the 3 and 6 months intervention to assess change

Study Arms (3)

Walking aid (WA) group

EXPERIMENTAL

Participants will receive the walking aid and training in the use of the device.

Device: Walking aid; Other: Guidance on safe walking and risk of falling

Walking aid with telemonitoring (WAT) group

EXPERIMENTAL

Participants will receive the walking aid and training in the use of the device associated with telemonitoring.

Device: Walking aid; Other: Telemonitoring; Other: Guidance on safe walking and risk of falling

Control group

OTHER

Participants will receive verbal guidance and printed material.

Other: Guidance on safe walking and risk of falling

Interventions

Walking aid DEVICE

A physiotherapist will identify the mobility needs and will indicate the most appropriate walking aid (cane or walker).

Walking aid (WA) group; Walking aid with telemonitoring (WAT) group

Telemonitoring OTHER

Telemonitoring will occur every two weeks for three months after the emergency department discharge, through video call (about 15 minutes). On these opportunities, the importance of using mobile devices and the guidance on safe gait will be reinforced.

Walking aid with telemonitoring (WAT) group

Guidance on safe walking and risk of falling OTHER

Participants will receive verbal guidance and printed material with guidance on safe walking and fall prevention.

Control group; Walking aid (WA) group; Walking aid with telemonitoring (WAT) group

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Older Adult (65+)

You may qualify if:

• years or older
• Admitted to the Geriatric Emergency Department of Hospital Sírio-Libanês
• Willing and able to give informed consent
• Least one of the following for indication and training of mobility aids: reduction of postural instability; improvement of motor control; increase of somatosensory feedback; reduction of biomechanical overload; safe promotion of autonomy; fall history (in the last six months).

You may not qualify if:

• Altered level of conscience
• need for supplemental oxygen (≥3L/min)
• respiratory distress
• hemodynamic instability
• postural instability with a tendency to fall backward
• cognitive impairment that limits the use of walking aids
• hospitalization after Emergency Department evaluation
• Delirium

Sponsors & Collaborators

• Hospital Sirio-Libanes: lead

Study Sites (1)

Hospital Sírio Libanês

São Paulo, São Paulo, 01308-050, Brazil

Location

Related Publications (7)

• Kennedy RE, Williams CP, Sawyer P, Lo AX, Connelly K, Nassel A, Brown CJ. Life-Space Predicts Health Care Utilization in Community-Dwelling Older Adults. J Aging Health. 2019 Feb;31(2):280-292. doi: 10.1177/0898264317730487. Epub 2017 Sep 14.

  PMID: 29254407 BACKGROUND

• Shimada H, Sawyer P, Harada K, Kaneya S, Nihei K, Asakawa Y, Yoshii C, Hagiwara A, Furuna T, Ishizaki T. Predictive validity of the classification schema for functional mobility tests in instrumental activities of daily living decline among older adults. Arch Phys Med Rehabil. 2010 Feb;91(2):241-6. doi: 10.1016/j.apmr.2009.10.027.

  PMID: 20159128 BACKGROUND

• Brown CJ, Kennedy RE, Lo AX, Williams CP, Sawyer P. Impact of Emergency Department Visits and Hospitalization on Mobility Among Community-Dwelling Older Adults. Am J Med. 2016 Oct;129(10):1124.e9-1124.e15. doi: 10.1016/j.amjmed.2016.05.016. Epub 2016 Jun 8.

  PMID: 27288857 BACKGROUND

• van den Berg N, Schumann M, Kraft K, Hoffmann W. Telemedicine and telecare for older patients--a systematic review. Maturitas. 2012 Oct;73(2):94-114. doi: 10.1016/j.maturitas.2012.06.010. Epub 2012 Jul 17.

  PMID: 22809497 BACKGROUND

• Bateni H, Maki BE. Assistive devices for balance and mobility: benefits, demands, and adverse consequences. Arch Phys Med Rehabil. 2005 Jan;86(1):134-45. doi: 10.1016/j.apmr.2004.04.023.

  PMID: 15641004 BACKGROUND

• Polesel FS, Denadai S, Morinaga CV, Madalena IC, Aliberti MJR, Henrique EA, de Andrade-Junior MC, Nucci RAB, Yamaguti WP, Curiati PK, Righetti RF. Walking Aids and Locomotion Training in the Emergency Department: A Randomized Clinical Trial. JAMA Netw Open. 2025 Nov 3;8(11):e2544535. doi: 10.1001/jamanetworkopen.2025.44535.

  PMID: 41269694 DERIVED

• Polesel FS, Denadai S, Aliberti MJR, Morinaga CV, Andrade-Junior MC, Madalena IC, Yamaguti WP, Curiati PK, Righetti RF. Training and provision of mobility aids to promote autonomy and mobility of older patients in a geriatric emergency department: A protocol for a randomized controlled trial. PLoS One. 2024 Jul 31;19(7):e0304397. doi: 10.1371/journal.pone.0304397. eCollection 2024.

  PMID: 39083494 DERIVED

MeSH Terms

Conditions

Mobility Limitation; Emergencies

Condition Hierarchy (Ancestors)

Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Disease Attributes; Pathologic Processes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Masking Details: This study will be blind for the researchers involved in the post-telemonitoring assessments. Also, the data will be analyzed by a researcher who is not involved in the interventions or the assessments.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 10, 2023
• First Posted: July 18, 2023
• Study Start: July 31, 2023
• Primary Completion: December 28, 2024
• Study Completion: December 28, 2024
• Last Updated: April 24, 2025

Record last verified: 2025-04

Locations

BR (1)